Nursing Assignment | Top Universities

Case Study B Subjective Medical History Ms. QS is a 53 yr old African American female who stands 65 in. tall, weighs 150 lb, and has a BMI of 25.0 kg .m2. She recently visited her primary care physician and was diagnosed with hyperlipidemia, with a recent LDL-C of 160 mg. dL-1. Her BP and HR are 128/72 mmHg and 74 bpm, respectively. Her physician prescribed Crestor 10mg, a low- dose daily statin, to lower her elevated LDL-C. Her physician also noted that her BP is considered to be elevated, but advised Ms. QS that her most critical health concerns are to get her blood lipids within normal ranges. Ms. QS is very worried that she will have to begin a blood-pressure lowering drug to reduce her BP and is trying to avoid this at all costs. She used to walk every day during lunch, but for the past 6 mo has not been able to due to increased workload. Objective and Laboratory Data Exercise Test Results During a recent maximal exercise test, Ms. QS achieved a HRmax of 160 beats: min-1 and BP of 190/76 mmHg. Her resting BP on that day was 132/74 mmHg. Immediately following exercise (i.e., 15 min),
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her BP returned to baseline values. She did not develop any significant arrhythmias or ST-segment changes. Of note, Ms. QS reported to her physician during a follow-up visit that her BP later that night was lower than it usually is in the evening (i.e., 120/70 mmHg). Assessment and Plan Diagnosis Ms. QS has dyslipidemia and elevated BP with an increased risk for developing future hypertension. Exercise Prescription Ms. QS achieved 96% of her age-predicted HRmax and did not appear to have an exaggerated BP response to exercise. Her stress test was negative for underlying cardiovascular ischemia. The initial aerobic exercise prescription should be set at a 30 min of light intensity (<40% VO2R or HRR) aerobic exercise, progressing gradually to 60 min of moderate-to-vigorous (40-75% VOR or HRR), > 5d/wk. Resistance training 2-3 d/wk at 50-69% 1RM and progressing to 70-85% 1RM should be emphasized to improve strength and <50% 1RM to improve muscle endurance and manage her other CVD risk factors such as LDL-C and elevated BP. Flexibility training >2-3 d/wk can be recommended for its general health benefits. Case Study Discussion Questions 1. What are some of the considerations for exercise prescription that Ms. QS should take into account given her specific health concerns? 2. Do you agree with the physician that Ms. QS may not need a prescription for a BP lowering drug right now? Why or why not? 3. How will the statin prescription impact Ms. QS’s use of lifestyle changes to target her elevated BP?. Get  Nursing Assignments  Help Today
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